HB 0441 2003
1	A bill to be entitled
2	An act relating to rural hospitals; amending ss. 395.602
3	and 408.07, F.S.; revising the definition of the term
4	"rural hospital"; providing that certain hospitals shall
5	be considered rural hospitals through a specified date and
6	that certain other hospitals may be designated rural
7	hospitals upon application to the Agency for Health Care
8	Administration; amending s. 395.6061, F.S.; providing that
9	rural hospitals are not required to obtain a certificate
10	of need for the construction of replacement facilities
11	under certain conditions; creating s. 395.6063, F.S.;
12	authorizing rural hospitals to contract with the
13	Department of Management Services to purchase coverage in
14	the state group health insurance plan for hospital
15	employees and qualified family members; providing for
16	employee and employer contributions; providing for an
17	annual administrative fee; providing an effective date.
18
19	Be It Enacted by the Legislature of the State of Florida:
20
21	Section 1. Paragraph (e) of subsection (2) of section
22	395.602, Florida Statutes, is amended to read:
23	395.602 Rural hospitals.--
24	(2) DEFINITIONS.--As used in this part:
25	(e) "Rural hospital" means an acute care hospital licensed
26	under this chapter, having 100 or fewer licensed beds and an
27	emergency room, which is:
28	1. The sole provider within a county with a population
29	density of no greater than 100 persons per square mile;
30	2. An acute care hospital, in a county with a population
31	density of no greater than 100 persons per square mile, which is
32	at least 30 minutes of travel time, on normally traveled roads
33	under normal traffic conditions, from any other acute care
34	hospital within the same county;
35	3. A hospital supported by a tax district or subdistrict
36	whose boundaries encompass a population of 100 persons or fewer
37	per square mile;
38	4. A hospital in a constitutional charter county with a
39	population of over 1 million persons that has imposed a local
40	option health service tax pursuant to law and in an area that
41	was directly impacted by a catastrophic event on August 24,
42	1992, for which the Governor of Florida declared a state of
43	emergency pursuant to chapter 125, and has 120 beds or less that
44	serves an agricultural community with an emergency room
45	utilization of no less than 20,000 visits and a Medicaid in-
46	patient utilization rate greater than 15 percent;
47	5. A hospital with a service area that has a population of
48	100 persons or fewer per square mile. As used in this
49	subparagraph, the term "service area" means the fewest number of
50	zip codes that account for 75 percent of the hospital's
51	discharges for the most recent 5-year period, based on
52	information available from the hospital inpatient discharge
53	database in the State Center for Health Statistics at the Agency
54	for Health Care Administration; or
55	6. A hospital designated as a Critical Access Hospital by
56	the Department of Health in accordance with federal regulations
57	and state requirements.
58
59	Population densities used in this paragraph must be based upon
60	the most recently completed United States census.A hospital
61	that received funds under s. 409.9116 for a quarter beginning no
62	later than July 1, 2002, is deemed to have been and shall
63	continue to be a rural hospital from that date through June 30,
64	2012, if the hospital continues to have 100 or fewer licensed
65	beds and an emergency room, or meets the criteria of
66	subparagraph 4. An acute care hospital that has not previously
67	been designated as a rural hospital and that meets the criteria
68	of this paragraph shall be granted such designation upon
69	application, including supporting documentation, to the Medicaid
70	program office of the Agency for Health Care Administration.
71	Section 2. Subsection (5) is added to section 395.6061,
72	Florida Statutes, to read:
73	395.6061 Rural hospital capital improvement.--There is
74	established a rural hospital capital improvement grant program.
75	(5) Notwithstanding the provisions of s. 408.036, a rural
76	hospital as defined in s. 395.602(2)(e) is not required to
77	obtain a certificate of need for the construction of a
78	replacement facility, provided the replacement facility is
79	located within 10 miles of the site of the currently licensed
80	rural hospital and within the current service area. As used in
81	this subsection, the term "service area" means the fewest number
82	of zip codes that account for 75 percent of the hospital's
83	discharges for the most recent 5-year period, based on
84	information available from the hospital inpatient discharge
85	database in the State Center for Health Statistics of the Agency
86	for Health Care Administration.
87	Section 3. Section 395.6063, Florida Statutes, is created
88	to read:
89	395.6063 Rural hospital employee health insurance.--Any
90	rural hospital as defined in s. 395.602(2)(e) may contract with
91	the Department of Management Services in order to purchase
92	coverage in the state group health insurance plan for the
93	hospital’s employees and qualified family members at the same
94	premium cost as that for retirees and surviving spouses. It
95	shall be the duty of the hospital to collect payroll deductions
96	or other remuneration from qualified employees as may be
97	required for the employee contribution in accordance with the
98	requirements of the Department of Management Services. It shall
99	also be the duty of the hospital to make the employer
100	contributions required and to pay an annual administrative fee
101	of not less than $2.61 per enrollee per month.
102	Section 4. Subsection (42) of section 408.07, Florida
103	Statutes, is amended to read:
104	408.07 Definitions.--As used in this chapter, with the
105	exception of ss. 408.031-408.045, the term:
106	(42) "Rural hospital" means an acute care hospital
107	licensed under chapter 395, having 100 or fewer licensed beds
108	and an emergency room, and which is:
109	(a) The sole provider within a county with a population
110	density of no greater than 100 persons per square mile;
111	(b) An acute care hospital, in a county with a population
112	density of no greater than 100 persons per square mile, which is
113	at least 30 minutes of travel time, on normally traveled roads
114	under normal traffic conditions, from another acute care
115	hospital within the same county;
116	(c) A hospital supported by a tax district or subdistrict
117	whose boundaries encompass a population of 100 persons or fewer
118	per square mile;
119	(d) A hospital with a service area that has a population
120	of 100 persons or fewer per square mile. As used in this
121	paragraph, the term "service area" means the fewest number of
122	zip codes that account for 75 percent of the hospital's
123	discharges for the most recent 5-year period, based on
124	information available from the hospital inpatient discharge
125	database in the State Center for Health Statistics at the Agency
126	for Health Care Administration; or
127	(e) A hospital designated as a Critical Access Hospital by
128	the Department of Health in accordance with federal regulations
129	and state requirements.
130
131	Population densities used in this subsection must be based upon
132	the most recently completed United States census.A hospital
133	that received funds under s. 409.9116 for a quarter beginning no
134	later than July 1, 2002, is deemed to have been and shall
135	continue to be a rural hospital from that date through June 30,
136	2012, if the hospital continues to have 100 or fewer licensed
137	beds and an emergency room, or meets the criteria of s.
138	395.602(2)(e)4. An acute care hospital that has not previously
139	been designated as a rural hospital and that meets the criteria
140	of this subsection shall be granted such designation upon
141	application, including supporting documentation, to the Medicaid
142	program office of the Agency for Health Care Administration.
143	Section 5. This act shall take effect July 1, 2003.
144